EXHIBIT 3:

Effects of specific conflict-of-interest policy restrictions on opioid prescribing volume at academic medical centers, 2013–16

					Brand-name opioids
	All opioids		Generic opioids		Not marketed		Marketed
Direct-to-physician marketing restriction	% diff.	SE	% diff.	SE	% diff.	SE	% diff.	SE
Gift and meal ban
Marginal effect	0.06	(1.46)	−0.26	(1.57)	−1.83	(9.87)	1.23	(3.32)
Speaking or consulting ban
Marginal effect	−1.51	(1.88)	−1.55	(1.90)	−24.30**	(11.20)	−0.77	(3.26)
Sales representative ban
Marginal effect	−4.73*	(2.78)	−4.87*	(2.71)	21.50	(17.1)	−11.00*	(5.75)
Disclosure requirement
Marginal effect	−2.46**	(1.18)	−2.56**	(1.21)	−0.41	(9.24)	−6.28**	(2.68)

source Authors’ analysis of data for 2013–16 from the Medicare Part D Prescriber Public Use File. notes Numbers of prescribers and prescriber-years are in the notes to exhibit 2. The restrictions are explained in the text.The exhibit presents semi-elasticity marginal effects from two-part models (explained in the text) that were estimated at the physician-year level. Standard errors (SEs) are clustered at the level of the academic medical center. Covariates include average beneficiary age, share of female beneficiaries, average beneficiary Hierarchical Condition Categories risk score, prescriber credential, and prescriber specialty. Fixed effects for year and academic calendar year are included in every model.

^*p < 0.10

^**p < 0.05